{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T09:12:44Z","timestamp":1694941964329},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,5,13]],"date-time":"2018-05-13T00:00:00Z","timestamp":1526169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Vedolizumab, a monoclonal antibody resulting in gut\u2010selective anti\u2010inflammatory activity, was approved by the <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> Food and Drug Administration in 2014 for use in patients with Crohn's disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>). The aim of this study was to investigate the efficacy of vedolizumab as a rescue therapy when other medical therapies have failed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective review was performed on consecutive patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> receiving vedolizumab at the Penn State Hershey <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> Center between May 2014 and March 2016. These patients were unresponsive or intolerant to tumour necrosis factor (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) antagonist therapy, and previously would have been candidates for surgery. Outcomes included surgical intervention, clinical response and endoscopic improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 48 patients with medically refractory <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> receiving vedolizumab were included. The median length of follow\u2010up was 69\u00a0weeks (range 15\u2013113\u00a0weeks). A majority (81%) of patients previously failed at least two <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> antagonists, and 77% had prior surgery for <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>. Surgical intervention was required in 21 (44%) patients and 13 (27%) patients required intra\u2010abdominal operations. At the conclusion of the study, 23 (48%) patients reported continued improvement of symptoms, and 22 of 37 (59%) patients undergoing endoscopy showed improvement. Patients with the inflammatory <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> phenotype were more likely to improve clinically and avoid surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vedolizumab alone or in combination with immunomodulators or steroids may be used as a rescue therapy in patients with medically refractory <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and may decrease the rate of surgical intervention. Patients with the inflammatory <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> phenotype had the best clinical response and decreased need for surgery, suggesting that vedolizumab is most effective in the inflammatory phenotype.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14225","type":"journal-article","created":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T20:01:42Z","timestamp":1524168102000},"page":"905-912","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vedolizumab as a rescue therapy for patients with medically refractory Crohn's disease"],"prefix":"10.1111","volume":"20","author":[{"given":"K. T.","family":"Crowell","sequence":"first","affiliation":[{"name":"Department of Surgery College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Tinsley","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. D.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. D.","family":"Coates","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bobb","sequence":"additional","affiliation":[{"name":"Department of Surgery College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. A.","family":"Koltun","sequence":"additional","affiliation":[{"name":"Department of Surgery College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Messaris","sequence":"additional","affiliation":[{"name":"Department of Surgery College of Medicine The Pennsylvania State University Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.11.041"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00159"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050516"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08512-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020732"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107829"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.109.153973"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215739"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.06.007"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.05.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000326"},{"key":"e_1_2_9_13_1","first-page":"412","article-title":"Long\u2010term efficacy of Vedolizumab for Crohn's disease","volume":"11","author":"Vermeire S","year":"2017","journal-title":"J Crohns Colitis"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw147"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.02.016"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.236"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13594"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i39.14393"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14459"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.201"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.14225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T06:27:38Z","timestamp":1694845658000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.14225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,13]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1111\/codi.14225"],"URL":"https:\/\/doi.org\/10.1111\/codi.14225","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,13]]},"assertion":[{"value":"2017-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}